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Bipolar disorder

Bipolar Disorder

Mental Health Awareness Module

What is Bipolar Disorder?

Bipolar disorder is a mental illness characterized by dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar experience extreme high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience.

Facts :

  • The average age-of-onset is about 18 years , but it can occur during adolescence . In more than 90 percent of individuals who manifest a single manic episode tend to have recurrent episodes, while in most cases a manic episode occurs before a depressive episode.

  • Worldwide statistics report a 2.4 percent prevalence of the disorder .

  • High-income countries have the highest prevalence of bipolar disorder and low-income countries have the lowest. The United States had the highest prevalence of overall (4.4%) and annual (2.8%) disease, while India had the lowest (0.1% for both).

  • Females are more likely to experience rapid cycling of mood and depressive symptoms compared to males.

  • The lifetime suicide risk is 15 times higher that of the general population..

Risk Factors

  • Bipolar disorder is more common in high income countries than low income countries.

  • Separated, divorced or widowed individuals have higher rates of Bipolar Disorder and family history is one of the strongest and most consistent risk factors for the disorder .

  • Although most people with bipolar disorder return to functional levels between episodes, about 30 percent show severe impairment in work .

  • Bipolar I and Bipolar II involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar Types

  • Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.

  • Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.

Diagnostic and statistical manual of mental disorders ( 5th ed.; DSM-5; American Psychiatric Association ,2013)

Bipolar Features

Manic Episode Signs

A manic episode is a period of at least one week when a person is very high spirited or irritable in an extreme way most of the day for most days, has more energy than usual and experiences at least three of the following, showing a change in behavior:

  • Feel very “up,” “high,” or “elated” – having exaggerated self esteem

  • Have a lot of energy

  • Have increased activity levels

  • Feel “jumpy” or “wired”

  • Have a decreased need for sleep

  • Become more active than usual

  • Talk really fast about a lot of different things

  • Be agitated, irritable, or “touchy”

  • Feel like their thoughts are going very fast

  • Think they can do a lot of things at once

  • Do risky things, like spend a lot of money or have reckless sex

It is important to remember that the mood disturbance is severe enough to cause marked impairment in social or occupational functioning or requiring hospitalization to prevent harm to self or others.

Hypomanic Episode

The hypomanic episode is similar to a manic episode (above) but the symptoms are less severe and need only last four days in a row. Hypomanic symptoms do not lead to the major problems or impairment in the social or occupational functioning that mania often causes and the person is still able to function.

  • Feel very “up,” “high,” or elated

  • Have a lot of energy

  • Have increased activity levels

  • Feel “jumpy” or “wired”

  • Have trouble sleeping

  • Become more active than usual

  • Talk really fast about a lot of different things

  • Be agitated, irritable, or “touchy”

  • Feel like their thoughts are going very fast

  • Think they can do a lot of things at once

  • Do risky things, like spend a lot of money or have reckless sex

Depressive Episode

A major depressive episode is a period of two weeks in which a person has at least five of the following (including one of the first two):

  • Intense sadness or despair; feeling helpless, hopeless or worthless

  • Loss of interest in activities once enjoyed

  • Feeling worthless or guilty

  • Sleep problems — sleeping too little or too much

  • Feeling restless or agitated (e.g., pacing or hand-wringing), or slowed speech or movements

  • Changes in appetite (increase or decrease)

  • Loss of energy, fatigue

  • Difficulty concentrating, remembering making decisions

  • Frequent thoughts of death or suicide

If left untreated, bipolar disorder usually worsens. However, with a good treatment plan including psychotherapy, medications, a healthy lifestyle, a regular schedule and early identification of symptoms, many people live well with the condition.


If you spot any warning signs of mania or depression, it is important to act quickly and have a wellness toolbox to manage symptoms . A wellness toolbox consists of coping skills and activities you can do to maintain a stable mood or to get better. The coping techniques that work best are individually related to your situation, symptoms, and preferences. It may require a bit of experimentation and time to find what works the best for you.

However, a number of studies demonstrate a link between the circadian rhythm and bipolar disorder. Disturbed sleep can be a cause of both depression or mania according to the John Duggan , a specialist on Bipolar disorder. Duggan has found that : “ both changing of seasons and sleep can have a profound affect on bipolar disorder.”

Wellness Toolbox: It is important to find the strategies that work best for you and consistently apply them.

  • Control Sleep by establishing a regular sleep routine : Go to bed at the same time every night, wake up at the same time every morning. If on medication take it at the same time daily.

  • Control Stress by establishing a bed time routine, if your mind is racing perform guided mediation –relaxation techniques – mind emptying techniques . Take a warm shower before going to bed, read a book, listen to relaxing music

  • Control stimulation by turning off all blue light devices smart phones, tablets etc.

  • Avoid napping in the afternoon if it interferes with your sleep at night.

  • Limit caffeine and alcohol after lunch.

  • Monitor your moods by keeping a journal to track your mood shifts ; there are a number of applications you may download on your phone or tablet or create a chart of your daily mood shifts.

  • Exercise daily- establish a routine of at least 30 minutes daily

  • Increase your exposure to daylight

  • Find time to relax and unwind during the day – Stress can trigger episodes of mania or depression – practicing relaxation techniques, guided imagery or mediation can improve your mood

  • Eat a healthy diet. There is an undeniable link between food and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains and limit your fat and sugar intake. Space your meals out through the day, so your blood sugar never dips too low.

  • High-carbohydrates can cause mood crashes, so they should also be avoided. Other mood-damaging foods include chocolate, caffeine, and processed foods.

  • Get your omega-3s. Omega-3 fatty acids may decrease mood swings in bipolar disorder. You can increase your intake of omega-3 by eating cold-water fish such as salmon, halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts. Omega-3 is also available as a nutritional supplement.

  • Don’t Isolate your self, connect face to face . Strong connections are important to staying happy and healthy.

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